Azacitidine vs. Decitabine in Unfit Newly Diagnosed Acute Myeloid Leukemia Patients: Results from the PETHEMA Registry

被引：6

作者：

Labrador, Jorge ^{[1
]}

Martinez-Cuadron, David ^{[2
]}

de la Fuente, Adolfo ^{[3
]}

Rodriguez-Veiga, Rebeca ^{[2
]}

Serrano, Josefina ^{[4
]}

Tormo, Mar ^{[5
]}

Rodriguez-Arboli, Eduardo ^{[6
]}

Ramos, Fernando ^{[7
]}

Bernal, Teresa ^{[8
]}

Lopez-Pavia, Maria ^{[9
]}

Trigo, Fernanda ^{[10
]}

Martinez-Sanchez, Maria Pilar ^{[11
]}

Rodriguez-Gutierrez, Juan-Ignacio ^{[12
]}

Rodriguez-Medina, Carlos ^{[13
]}

Gil, Cristina ^{[14
]}

Belmonte, Daniel Garcia ^{[15
]}

Vives, Susana ^{[16
]}

Foncillas, Maria-Angeles ^{[17
]}

Perez-Encinas, Manuel ^{[18
]}

Novo, Andres ^{[19
]}

Recio, Isabel ^{[20
]}

Rodriguez-Macias, Gabriela ^{[21
]}

Bergua, Juan Miguel ^{[22
]}

Noriega, Victor ^{[23
]}

Lavilla, Esperanza ^{[24
]}

Roldan-Perez, Alicia ^{[25
]}

Sanz, Miguel A. ^{[2
]}

Montesinos, Pau ^{[2
]}

机构：

[1] Complejo Asistencial Univ Burgos, Res Unit, Hematol Dept, Burgos 09006, Spain

[2] Hosp Univ & Politecn La Fe, Hematol Dept, Valencia 46026, Spain

[3] MD Anderson Canc Ctr Madrid, Hematol Dept, Madrid 28033, Spain

[4] Hosp Univ Reina Sofia, Hematol Dept, IMIBIC, Cordoba 14004, Spain

[5] Hosp Clin Univ Valencia, Inst Invest Sanitaria INCLIVA, Hematol Dept, Valencia 46010, Spain

[6] Hosp Univ Virgen Rocio, Hematol Dept, Inst Biomed Sevilla, IBIS,CSIC, Seville 41013, Spain

[7] Hosp Univ Leon, Hematol Dept, Leon 24071, Spain

[8] Hosp Univ Cent Asturias, ISPA, IUOPA, Hematol Dept, Oviedo 33011, Spain

[9] Hosp Gen Valencia, Hematol Dept, Valencia 46026, Spain

[10] Ctr Hosp Univ Sao Joao, Hematol Dept, P-4200319 Porto, Portugal

[11] Hosp Univ 12 Octubre, Hematol Dept, Madrid 28041, Spain

[12] Hosp Univ Basurto, Hematol Dept, Bilbao 48013, Spain

[13] Hosp Univ Gran Canaria Doctor Negrin, Hematol Dept, Las Palmas Gran Canaria 35010, Spain

[14] Hosp Gen Univ Alicante, Hematol Dept, Alicante 03010, Spain

[15] Hosp Univ Sanitas La Zarzuela, Hematol Dept, Madrid 28023, Spain

[16] Univ Autonoma Barcelona, Josep Carreras Res Inst, Hosp Germans Trias & Pujol ICO, Hematol Dept, Badalona 08916, Spain

[17] Hosp Univ Infanta Leonor, Hematol Dept, Madrid 28031, Spain

[18] Hosp Clin Univ Santiago De Compostela, Hematol Dept, Santiago De Compostela 15706, Spain

[19] Hosp Univ Son Espases, Hematol Dept, Palma De Mallorca 07120, Spain

[20] Complejo Asistencial Avila, Hematol Dept, Avila 05071, Spain

[21] Hosp Gen Univ Gregorio Maranon, Hematol Dept, Madrid 28007, Spain

[22] Hosp San Pedro Alcantara, Hematol Dept, Caceres 10003, Spain

[23] Hosp Univ A Coruna, Hematol Dept, La Coruna 15006, Spain

[24] Hosp Univ Lucus Augusti, Hematol Dept, Lugo 27003, Spain

[25] Hosp Univ Infanta Sofia, Hematol Dept, San Sebastian De Reyes 28702, Spain

来源：

CANCERS | 2022年 / 14卷 / 09期

关键词：

acute myeloid leukemia; elderly; treatment; azacitidine; decitabine; hypomethylating agents; PETHEMA; OLDER PATIENTS; INTERNATIONAL PHASE-3; OUTCOMES; CARE; AML; RECOMMENDATIONS; MULTICENTER; VENETOCLAX; THERAPY; ADULTS;

D O I：

10.3390/cancers14092342

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary The use of azacitidine (AZA) and decitabine (DEC) have allowed more elderly acute myeloid leukemia (AML) patients to be treated. However, scarcely any direct comparative data exist between both drugs. This study shows no significant differences in response rates or overall survival (OS) between upfront AZA and DEC treatment in a large retrospective with long-term follow-up cohort of AML patients. However, we identified for the first time the baseline characteristics of patients benefitting from AZA vs. DEC in terms of responses, 120-day mortality and OS. We also show differences in salvage treatment patterns and outcomes after failure to both hypomethylating agents in a real-life setting. Taken together, these findings could help to select the most appropriate hypomethylating agent in monotherapy. The hypomethylating agents, decitabine (DEC) and azacitidine (AZA), allowed more elderly acute myeloid leukemia (AML) patients to be treated. However, there are little direct comparative data on AZA and DEC. This multicenter retrospective study compared the outcomes of AZA and DEC in terms of response and overall survival (OS). Potential predictors associated with response and OS were also evaluated. A total of 626 AML patients were included (487 treated with AZA and 139 with DEC). Response rates were similar in both groups: CR was 18% with AZA vs. 23% with DEC (p = 0.20), CR/CRi was 20.5% vs. 25% (p = 0.27) and ORR was 32% vs. 39.5% (p = 0.12), respectively. Patients with leukocytes < 10 x 10(9)/L, bone marrow blasts < 50% and ECOG >= 2 had higher ORR with DEC than with AZA. OS was similar in both groups: 10.4 months (95% CI: 9.2-11.7) vs. 8.8 months (95% CI: 6.7-11.0, p = 0.455), for AZA and DEC, respectively. Age (>= 80 years), leukocytes (>= 10 x 10(9)/L), platelet count (<20 x 10(9)/L) and eGFR (>= 45 mL/min/1.73 m(2)) were associated with higher OS with AZA compared to DEC. In conclusion, we found no differences in response and OS rates in AML patients treated with AZA or DEC.

引用

页数：16

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